Meeting autistic people's mental health needs

Some autistic people may have high support needs. Services in the community can struggle to meet those needs, or those services might be lacking. For example, some people may show signs of distressed behviour or their mental health needs might require ‘assessment and treatment’.

At the National Autistic Society, we campaign for better services for autistic people across the country. We want to try and prevent people from being admitted as an inpatient to mental health hospitals. In some cases, the way that an autistic person behaves can be mistaken for a sign of mental illness. We know that this is incorrect, and the Mental Health Act Code of Practice is clear that this alone does not justify someone being ‘sectioned’. This can be an issue for many autistic people, regardless of whether they communicate using speech, or their IQ.

The Code of Practice also says that “compulsory treatment in a hospital setting is rarely likely to be helpful,” for an autistic person. We highlighted many of the issues that autistic people and their families face through our Transforming Care campaign. 

It is vital that all health professionals understand autism and the needs of autistic people (including communication and sensory needs) across the whole spectrum. Services should meet these needs, provide personalised support and avoid a ‘one size fits all’ approach.

Some autistic people find themselves at risk of admission into, or in mental health hospitals (or assessment and treatment units), where they do not receive appropriate support. Sadly, once someone is in an inpatient setting, it can be very hard to get back home.

My relative or person I care for is at risk of admission to a mental health hospital

If you have been told that your relative is at risk of being admitted to a mental health hospital (this might be called being ‘sectioned’ under the Mental Health Act), you can ask for a Care and Treatment Review (CTR). You may also find the Mental Health Act Code of Practice useful to read, as this is the guidance that mental health professionals should be following. It highlights the need for support from professionals who understand autism.

CTRs involve commissioners, clinicians and someone with lived experience known as an ‘expert by experience’. They ask questions about the care and support that a person needs, and they can be important in preventing people being admitted to hospital. CTR guidance for the NHS was updated to include more questions to identify autistic people’s needs and it is important these are used.

My relative or person I care for is in a mental health hospital

If your relative is in a mental health hospital, it’s important to know what their rights are. 

Mencap has produced guides for families in this situation. MIND also has a section of its website about legal rights under the Mental Health Act that could be very helpful.

It is also important that people who are in mental health hospitals have a CTR regularly. This should plan the care and support that someone needs to be discharged from hospital as soon as possible. Actions identified in the CTR need to be progressed and the CTR should be regularly reviewed. The Bringing Us Together guide for families will help explain this process. The organisation CHANGE has also produced a toolkit and a planner to help shape plans for discharging people from mental health hospitals.

Bringing Us Together and Mencap’s guides also contain useful information about what to do if you have concerns about the medication that your relative is on. The National Autistic Society has signed up to the STOMP pledge, to make sure that medication is not overused and we encourage more providers to sign up.

Working with the NHS, we have produced a guidebook for autistic adults, their families and carers. It gives you more information about why the medication might be prescribed, possible side-effects, medication reviews and information on monitoring your own health and wellbeing. It also includes a workbook that you can use to help prepare for a medication review. You can download a free copy of Stopping The Over-Medication of People (STOMP): a resource for autistic people and their families from our online shop.

My relative or person I care for has been discharged from a mental health hospital

When someone has been discharged, the aim is to make sure that all the care and support that they need is provided, so that they are not admitted to hospital again.

For people that have been in a mental health hospital, there are particular rights to ‘aftercare’ in s.117 of the Mental Health Act.

Your next steps 

• Contact our Autism Inpatient Mental health casework service for advice in England on preventing or challenging detention and securing the care and support autistic people need in their communities
• Visit our autism and mental health website page
• Read our guides on autism and communication
• Email our policy team to find out more about our latest mental health campaigns or visit our Campaigns page.

Useful resources

• Challenging Behaviour Foundation - support for families of people with learning disabilities and distressed behaviour.
• Mencap’s Learning Disability Helpline - support for people with a learning disability (including autistic people) or their families. 
• MIND - advice and information about mental health and being admitted to mental health hospitals, for adults.
• YoungMinds - advice and information about mental health for parents of children with mental health difficulties.
• Bringing us together - a guide for families with information on CTR, written by a group of parents.
• CHANGE: The Discharge Toolkit and Planner - two new resources to help patients in specialist learning disability or mental health hospital services plan for leaving hospital.

Resources on the law surrounding mental health hospitals and getting the right support

• CASCAIDr (Centre for Adults’ Social Care – Advice, Information and Dispute Resolution)
• Rights in Reality - a blog written by barrister Steve Broach. The blog includes a list of solicitors with experience in disability and SEND cases.